NR 565: Advanced Pharmacology Fundamentals Week 5 Chapter 24
Week 5: chapter 24, Pages 692-760
i i i i i
Penicillins i– iinhibit icell iwall isynthesis
Used ito ibroaden itheir ispectrum iare iclauvenate i(augmentin--increases idiarrhea irisk)
Gram ipositives i(e icoli, isalmonella, ienterococcus)
iAbsorbed ifrom iGI itract
Rash, idiarrhea, iN/V, ihypersensitivity i– icommon iadverse ieffects; itypically ioccur i15-30
imin iafter itaking
Pregnancy iclass iB
Acute iotitis imedia iand isinusitis i– iamoxicillin
iStreptococcal i pharyngitis i – i penicillin
iAnimal ibite i– iaugmentin
Reevaluate iand iask i“are isymptoms igetting iany ibetter?”
Cephalosporins
4 igenerations
1st i: iskin, i cellulitis; i gram i +bacteria
2nd: isame i as i first, i but i also i protozeas, i e i coli; i gram i +bacteria
i3
rd:igram i -bacteria, i broader/wider i spectrums
th:
4 igram i +bacteria, i resistant i to i beta i lactamase
iAbsorbed ifrom iGI itract
GI idisturbances, irash, icross isensitivity iwith iPCN, icoagulation iabnormalities!!!,ineutropenia,
iseizures, irenal/hepatic ifailure i– icommon iadverse ieffects
*Cephalexin ialso iused ifor iUTIs, icefpodoxime, iceftriaxone
Take ithe iwhole icourse; iuse ias iprescribed, ino ialcohol, itake iwith ifood ior imilk
Fluoroquinolones
Inhibit iDNA isynthesis
Gram i-bacteria
Not irecommended ifor ianyone i18 ior iunder ior ipregnant
iIncreased iresistance ibecause iof ioverprescribing
(Can’t ibe iused ifor igonorrhea ior isyphilis ifor ithat ireason)
Avoid iwith itendon irupture, iphototoxicity, iCNS idisorders, irenal/hepatic ifailure,iAFib/Aflutter
ito iprolong iQTc
ECG ibefore iprescribing; idon’t ileave ithem ion ithese ifor iLT iuse
*Food idelays iabsorption; itake iwith ia ifull iglass iof iwater, i2-6 ihours ifrom iother idrugs
-tender itendons; istop imedication iand icall iprovider
Lincosamides
Inhibits iprotein isynthesis
, Gram i+bacteria
Not iaffected iby igastric iacid; icompletely iabsorbed ias ithey’re itaken
iCommon ieffects i– isevere icolitis**, imetallic itaste, ineutrocytopenia
First iline iused ifor i iMRSA, idental iinfections, idrug iresistance istrep ior iPNAiClindamycin
iis ifirst iline itherapy iin iwhat ipopulation? iKids i& ipregnancy
*Monitor ifor idiarrhea; istop itaking iif isignificant
Macrolides i(erythromycin)
Inhibits iRNA idependent iprotein isynthesis
Well iabsorbed iin iduodenum; iinhibits iCYP i450 i3A4
*Can’t icombine iwith istatin; ican iincrease irisk ifor imyopathyiSafe
iwith ikids iand ipregnancy
Don’t iuse iwith iliver idisease, inot iin iacute iotitis imedia, irisk iof iQTC, iinhibitors ifor iCYP i450
i3A4; isteven ijohnson isyndrome, itorsades, ieczema
Drug iof ichoice ifor icommunity iacquired iPNA… ialso ipertussis i& ichlamydia
iBackup ialternative ifor ipeople iwith iPCN iallergies
Monitor ihepatic/renal ilabs, ican icause iimpairment
*Watch ihearing iloss; iother imedication irxns
Sulfonamides
Inhibits ifolic iacid isynthesis
Watch ifor istomatitis, ihypersensitivity, iphotosensitivity, iHA, idizziness, irash, iGI
iUsed ifor iUTIs
Low-cost ialternative
*long iterm iuse ifor iUTI; icheck iCBC, icheck ieffectiveness iand iif iyou ineed ia ichange
Trimethoprim
Inhibits iDNA isynthesis
Watch ifor istomatitis, ihypersensitivity, iphotosensitivity, iHA, idizziness, irash, iGI
iUsed ifor iUTIs
Low-cost ialternative
*long iterm iuse ifor iUTI; icheck iCBC, icheck ieffectiveness iand iif iyou ineed ia ichange
Nitrofurantoin
Inhibits iacetyl icoenzymes isynthesis
Watch ifor istomatitis, ihypersensitivity, iphotosensitivity, iHA, idizziness, irash, iGI
iUsed ifor iUTIs
Low-cost ialternative
*long iterm iuse ifor iUTI; icheck iCBC, icheck ieffectiveness iand iif iyou ineed ia ichange
*If icough idevelops, iget iCXR!
Lipoglycopeptides
Vancomycin i– inot iabsorbed iwell iorally i(unless ifor iCDif)
Common iadverse ieffects i– iredman isyndrome, iototoxicity, inephrotoxicityiUsed
ifor igram+bacteria
Renal ifunction ishould ibe imonitored
Chapter 26 – drugs used in treating ear and eye disordersEye
i i i i i i i i i i i
Disorders
i
Week 5: chapter 24, Pages 692-760
i i i i i
Penicillins i– iinhibit icell iwall isynthesis
Used ito ibroaden itheir ispectrum iare iclauvenate i(augmentin--increases idiarrhea irisk)
Gram ipositives i(e icoli, isalmonella, ienterococcus)
iAbsorbed ifrom iGI itract
Rash, idiarrhea, iN/V, ihypersensitivity i– icommon iadverse ieffects; itypically ioccur i15-30
imin iafter itaking
Pregnancy iclass iB
Acute iotitis imedia iand isinusitis i– iamoxicillin
iStreptococcal i pharyngitis i – i penicillin
iAnimal ibite i– iaugmentin
Reevaluate iand iask i“are isymptoms igetting iany ibetter?”
Cephalosporins
4 igenerations
1st i: iskin, i cellulitis; i gram i +bacteria
2nd: isame i as i first, i but i also i protozeas, i e i coli; i gram i +bacteria
i3
rd:igram i -bacteria, i broader/wider i spectrums
th:
4 igram i +bacteria, i resistant i to i beta i lactamase
iAbsorbed ifrom iGI itract
GI idisturbances, irash, icross isensitivity iwith iPCN, icoagulation iabnormalities!!!,ineutropenia,
iseizures, irenal/hepatic ifailure i– icommon iadverse ieffects
*Cephalexin ialso iused ifor iUTIs, icefpodoxime, iceftriaxone
Take ithe iwhole icourse; iuse ias iprescribed, ino ialcohol, itake iwith ifood ior imilk
Fluoroquinolones
Inhibit iDNA isynthesis
Gram i-bacteria
Not irecommended ifor ianyone i18 ior iunder ior ipregnant
iIncreased iresistance ibecause iof ioverprescribing
(Can’t ibe iused ifor igonorrhea ior isyphilis ifor ithat ireason)
Avoid iwith itendon irupture, iphototoxicity, iCNS idisorders, irenal/hepatic ifailure,iAFib/Aflutter
ito iprolong iQTc
ECG ibefore iprescribing; idon’t ileave ithem ion ithese ifor iLT iuse
*Food idelays iabsorption; itake iwith ia ifull iglass iof iwater, i2-6 ihours ifrom iother idrugs
-tender itendons; istop imedication iand icall iprovider
Lincosamides
Inhibits iprotein isynthesis
, Gram i+bacteria
Not iaffected iby igastric iacid; icompletely iabsorbed ias ithey’re itaken
iCommon ieffects i– isevere icolitis**, imetallic itaste, ineutrocytopenia
First iline iused ifor i iMRSA, idental iinfections, idrug iresistance istrep ior iPNAiClindamycin
iis ifirst iline itherapy iin iwhat ipopulation? iKids i& ipregnancy
*Monitor ifor idiarrhea; istop itaking iif isignificant
Macrolides i(erythromycin)
Inhibits iRNA idependent iprotein isynthesis
Well iabsorbed iin iduodenum; iinhibits iCYP i450 i3A4
*Can’t icombine iwith istatin; ican iincrease irisk ifor imyopathyiSafe
iwith ikids iand ipregnancy
Don’t iuse iwith iliver idisease, inot iin iacute iotitis imedia, irisk iof iQTC, iinhibitors ifor iCYP i450
i3A4; isteven ijohnson isyndrome, itorsades, ieczema
Drug iof ichoice ifor icommunity iacquired iPNA… ialso ipertussis i& ichlamydia
iBackup ialternative ifor ipeople iwith iPCN iallergies
Monitor ihepatic/renal ilabs, ican icause iimpairment
*Watch ihearing iloss; iother imedication irxns
Sulfonamides
Inhibits ifolic iacid isynthesis
Watch ifor istomatitis, ihypersensitivity, iphotosensitivity, iHA, idizziness, irash, iGI
iUsed ifor iUTIs
Low-cost ialternative
*long iterm iuse ifor iUTI; icheck iCBC, icheck ieffectiveness iand iif iyou ineed ia ichange
Trimethoprim
Inhibits iDNA isynthesis
Watch ifor istomatitis, ihypersensitivity, iphotosensitivity, iHA, idizziness, irash, iGI
iUsed ifor iUTIs
Low-cost ialternative
*long iterm iuse ifor iUTI; icheck iCBC, icheck ieffectiveness iand iif iyou ineed ia ichange
Nitrofurantoin
Inhibits iacetyl icoenzymes isynthesis
Watch ifor istomatitis, ihypersensitivity, iphotosensitivity, iHA, idizziness, irash, iGI
iUsed ifor iUTIs
Low-cost ialternative
*long iterm iuse ifor iUTI; icheck iCBC, icheck ieffectiveness iand iif iyou ineed ia ichange
*If icough idevelops, iget iCXR!
Lipoglycopeptides
Vancomycin i– inot iabsorbed iwell iorally i(unless ifor iCDif)
Common iadverse ieffects i– iredman isyndrome, iototoxicity, inephrotoxicityiUsed
ifor igram+bacteria
Renal ifunction ishould ibe imonitored
Chapter 26 – drugs used in treating ear and eye disordersEye
i i i i i i i i i i i
Disorders
i
